应用彩色多普勒血流成像技术对后部缺血性视神经病变的研究

目的:探讨后部缺血性视神经病变(posterior ischenic optic neuropathy,PION)患者颈动脉及眼血流动力学的改变。方法:应用彩色多普勒血流成像技术(color Doppler flow imaging,CDFI)观察14例19眼PION患者,检测颈总动脉和颈内动脉影像学特征、睫状后动脉(posterior ciliary arteries,PCAs)和视网膜中央动脉(central retinal artery,CRA)血流动力学变化,与患者未受累一侧眼进行比较。结果:14例PION患者中12例(86%)表现为双侧颈总动脉和颈内动脉内膜粗糙、增厚,9例(64%)探查到血管壁斑块回声,硬斑5例,混合斑5例,软斑3例;PCAs的收缩期峰值速度(peaksy stolic velocity,PSV)为27.60±16.7cm/s,阻力指数(resistance index,RI)为0.84±0.038,与对照眼比较PSV无显著降低,RI明显增高(t=2.116,P<0.05);CRA的PSV为11.51±3.47cm/s,RI为0.75±0.036,与对照眼比较PSV无差异,RI增高非常明显(t=2.862,P<0.01)。结论:PION的发生主要与颈动脉粥样硬化导致的颈动脉系统血流变化有关,CDFI对明确PION诊断有重要的应用价值。

Research on posterior ischemic optic neuropathy using color Doppler flow imaging

AIM:To investigate changes on carotid artery and ocular hemodynamics in patients with posterior ischemic optic neuropathy(PION).·METHODS: Nineteen eyes (14 patients )with PION were studied by using color Doppler flow imaging( CDFI),morphology characteristics of arteriae carotis communis and internal carotid artery were detected,and also the hemodynamics of the posterior ciliary arteries (PCAs) and the central retinal artery(CRA)were detected,the other eye not involved was as control group.·RESULTS: Among 14 cases with PION,12 cases (86%) displayed rough and thickening endarterium of double arteriae carotis communis and internal carotid artery,9 cases (64%) showed plaque echo vessel wall,including 5 cases with hard plaquing,5 cases with combine,3 cases with soft plaque;peak systolic velocity(PSV) and resistance index(RI) of PCAs was 27.60±16.7cm/s and 0.84±0.038 respectively,and in the comparison with the control eye,RI increased significantly(t=2.116,P<0.05);PSV and RI of CRA was 11.51±3.47cm/s and 0.75±0.036 respectively,RI increased obviously significant(t=2.862,P<0.01).·CONCLUSION: Development of PION is mainly related to changes of carotid artery system blood flow resulted from carotid artherosclerosis,CDFI is a valuable method to diagnosis PION.